Telemedicine System

A Telemedicine System is a digital healthcare service that uses telecommunications technology.

• AKA: Remote Clinical Care, Remote Diagnosis and Treatment.
• Context:
  • It can range from being a Office-based Telemedicine to being a Hospital-based Telemedicine.
  • It can be provided when distance separates the patients and health care provider.
  • ...
• Example(s):
  • Medication-Assisted Treatment Through Telemedicine (Tele-MAT),
  • Teledentistry,
  • Teleneurology,
  • Telecardiology,
  • Telepsychiatry,
  • Teleradiology,
  • Telesurgery.
  • ...
• Counter-Example(s):
  • Telehealth,
  • Telerehabilitation,
  • mHealth,
  • eHealth,
  • Robot-assisted Surgery,
  • Walk-In Clinic,
  • Emergency Room,
  • Satmed.
• See: Videotelephony, Videoconferencing, Health Data, Telecommunication, Clinician, Decentralized Clinical Trials.

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References

2021

• (Wikipedia, 2021) ⇒ https://en.wikipedia.org/wiki/Telehealth Retrieved:2021-9-26.
  • Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies.

"TeleHealth". The Health Resources and Services Administration. 2017-04-28.</ref> It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Shaw DK (June 2009). "Overview of telehealth and its application to cardiopulmonary physical therapy". Cardiopulmonary Physical Therapy Journal. 20 (2): 13–8. doi:10.1097/01823246-200920020-00003. PMC 2845264. PMID 20467533.</ref>  Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap  as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Mashima PA, Doarn CR (December 2008). “Overview of telehealth activities in speech-language pathology". Telemedicine Journal and E-Health. 14 (10): 1101–17. doi:10.1089/tmj.2008.0080. PMID 19119834</ref> Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.   Miller EA (July 2007). “Solving the disjuncture between research and practice: telehealth trends in the 21st century". Health Policy. 82 (2): 133–41. doi:10.1016/j.healthpol.2006.09.011. PMID 17046097.</ref>

2018

• (NEJM C., 2018) ⇒ NEJM Catalyst (2018). "What Is Telehealth?"
  • QUOTE: The terms telehealth and telemedicine are often used interchangeably, but telehealth has evolved to encapsulate a broader array of digital healthcare activities and services. To understand the juxtaposition of telehealth and telemedicine, it is essential first to define telemedicine.

    What is Telemedicine?

    Oxford’s telemedicine definition is “the remote diagnosis and treatment of patients by means of telecommunications technology” Telemedicine encompasses the use of technologies and telecommunication systems to administer healthcare to patients who are geographically separated from providers. For example, a radiologist may read and interpret the imaging results for a patient in a different county whose hospital does not currently have a radiologist on staff. Or a physician may conduct an urgent-care consultation via video for a non-life-threatening condition.

    Where telemedicine refers specifically to the practice of medicine via remote means, telehealth is a blanket term that covers all components and activities of healthcare and the healthcare system that are conducted through telecommunications technology. Healthcare education, wearable devices that record and transmit vital signs, and provider-to-provider remote communication are examples of telehealth activities and applications that extend beyond remote clinical care.

2012

• (Nesbitt, 2012) ⇒ Thomas S. Nesbitt (2012). "The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary". In: Board on Health Care Services; Institute of Medicine. Washington (DC): National Academies Press (US).
  • QUOTE: Telemedicine has also been used for decades in clinical settings. In 1906, the inventor of the electrocardiogram published a paper on the telecardiogram. Since the 1920s, the radio has been used to give medical advice to clinics on ships. Alaska has been a model for the development and use of telemedicine for decades. For example, community health aides in small villages can perform otoscopy and audiometry, and the information can be sent to specialists in Anchorage or Fairbanks to make the determination of whether a patient needs to travel to the specialist for more definitive treatment. Today, we think of office-based telemedicine as flat-screen, high-definition units with peripheral devices that can aid in physical examination of the patient (...)

    Probably one of the earliest and most famous uses of hospital-based telemedicine was in the late 1950s and early 1960s when a closed-circuit television link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital for psychiatric consultations. Hospital-based telemedicine is growing quickly in two areas: stroke care and care in the intensive care unit (ICU). Evidence shows that with good imaging, high-quality stroke exams can be done over distance. Although the literature on tele-ICU has been mixed, recent studies indicate associated reductions in length of stay, mortality, and costs.

2009

• (Shaw, 2009) ⇒ Donald K Shaw (2009). "Overview of Telehealth and Its Application to Cardiopulmonary Physical Therapy". In: Cardiopulmonary Physical Therapy Journal.
  • QUOTE: It is inevitable that new technology brings with it a new or unique terminology; telemedicine is no exception to this observation. Hetherington defines telemedicine as, “a form of medical clinical activity that relies on telecommunicated information exchange for consultation, medical diagnosis, and patient care.” Grigsby and Saunders view telemedicine as, “the use of electronic information and communication technologies to provide and support health care when distance separates the participants.” These same authors, in an effort to expand this definition to include allied health professions, also perceive telemedicine as, “encompassing all of the health care, education, information, and administrative services that can be transmitted over distances by telecommunication technologies" . Considerable confusion arises, however, when similar concepts are identified with different words: telemedicine vs. telehealth. The problem was initially exacerbated when much of the physical therapy literature appeared to reference the word “telehealth” preferentially. Although the concepts embraced are similar, there are important differences (Table1). Therefore, in an effort to offer “… clarification between similar terms” and to present guidelines for telehealth use, the APTA Board of Directors (BOD) authored Telehealth – Definitions and Guidelines. This document provided the operational definition of telehealth as follows:

Table 1: Telemedicine Terminology.

Word	Definition
Telehealth	The use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.
Telemedicine	The use of telecommunications technology for medical diagnostic, monitoring, and therapeutic purposes when distance separates the users.
Telerehabilitation	The use of electronic communication and information technologies to provide rehabilitation at a distance.
Consult	A telehealth consultation whereby a patient's primary care provider consults with a specialist at a distant site while care remains the responsibility of the patient's primary care provider.
Encounter	A telehealth event involving patient contact such as a patient being treated directly by a provider at a distant site or cases involving the patient along with providers at both the distant and originating site.
Analog Transmission	A transmitted signal whose frequency is proportional to the source voltage and having limited bandwidth (eg, standard telephone).
Digital Transmission	A transmitted signal whose voltage is converted to numeric values which are sent in sequential order from source to destination (eg, physiologic data).
Store-and-Forward	Information that is stored in a specific format and sent to a consulting provider for a diagnosis, interpretation, confirmatory opinion, second opinion, or for any reason that the input of the consulting provider is requested.
Real Time	Information sent from originating site to receiving site as it occurs rather than being stored for later transmission.

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